Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
Guidance Document Change: This is a new form used to determine whether DMAS will cover certain weight loss drugs. (This process is called service authorization.)
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9/15/23  12:33 pm
Commenter: Dr. Pamela Brandt

Importance of medicaiton access for obesity treatment

As a physician who provides obesity care and is trained in Internal Medicine, I know without a doubt the damage that will be done when patients cannot access medications for assistance with obesity treatment. The fact that this refers to "weight loss medication" is telling. Using tools to treat obesity is not about the weight loss, but weight loss is one tool for managing chronic disease. 

The evidence is clear that excess adipose tissue (resulting in higher body weight) is a major factor influencing the risk of many disease states, including cardiovascular disease, diabetes, NAFLD (quickly becoming the most common cause of liver transplants in this country) and cancer. We also know that both relatively small and large losses of body fat improves these outcomes and reduces the risk of disease. Until recently, we have not had studies that show these hard outcomes because we have not had adequate tools to create the body weight loss necessary to see that signal in the data. 

Based on the information in the SELECT trial of Semaglutide, we now have proof that use of medication can not only drive weight loss but also lead to decreases in adverse cardiovascular outcomes such as stroke and heart attack. 

For many years I practiced in an environment where patients with medicaid did not have access to the gold standard of medications to treat obesity, and in the last year I have been able to offer my patients life changing treatment. Many patients have resolved or significantly improved their diabetes, been able to get their knee replacements, or come off of their blood pressure medications. I have had patients that are able to recieve a kidney transplant and lung transplant because their BMI finally qualified. THIS IS NOT JUST ABOUT WEIGHT LOSS. IT IS A TOOL FOR SURVIVAL. 

I refuse to believe that we would be back to allowing the patients with the most need to not have a tool that we know would change their lives. Because a patient does not have an employer providing insurance coverage should not mean that they die on a transplant list, or continue to be bed bound because of their severe osteoarthritis pain. Patients shouldn't need dialysis because their diabetes remains severely uncontrolled. 

My patients need access to obesity treatment. 

Thank you. 


CommentID: 220343